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Biomedical subjects

J Gray

Publications and source records attributed to J Gray.

At least 235 records · Page 13Linked to original sources
PubMed1995

An outbreak of campylobacter food poisoning in a health care setting.

An outbreak of campylobacter food poisoning in a group of health care workers is reported. The outbreak involved 12 of 31 staff members attending a departmental party. Investigations revealed that a chicken dish was the most likely vehicle of infection. The relative risk of developing symptoms after eating this dish was 6.15 (P < 0.002). Further investigation established that not only had the cooking instructions been misunderstood but storage of the the food the morning of the party did not comply with Department of Health guidelines. The outbreak was associated with considerable morbidity and cost. It is important that health care workers other than professional catering staff are aware of the guidelines available to ensure the correct preparation and storage of food if such events are to be held in hospital departments. It is also important that manufacturers of chicken products ensure that labelling regarding further cooking is clear and in large print.

Campylobacter Infections↗
PubMed1995

Operating needle exchange programmes in the hills of Thailand.

Injecting drug use is increasingly markedly amongst the ethnically distinct Hilltribe peoples of northern Thailand in the notorious 'Golden Triangle'. This paper reports on the establishing of needle exchanges in three remote Hilltribe villages, examining the success and the failure. Up to 60% of adult males and a smaller percentage of adult females in these villages are habitual users of opium and/or heroin. Overcoming initial concern that needle distribution would encourage increased use, the villagers themselves have assumed responsibility for much of the needle exchange operation. Prior to the introduction of the needle exchanges all the injecting drug users were sharing needles. This behaviour changed significantly with the introduction of the exchanges. Reluctance on the part of locally-based government officials to participate fully in the programme created difficulties in maintaining needle supplies which saw some resumption in needle sharing. HIV seroprevalence rates amongst the tested injecting drug users remained fairly stable at 33% in February 1993 and 32% in February 1994. The conclusion can be drawn that needle exchange programmes are operable in the Hilltribe context and that they are the best means of limiting HIV/AIDS transmission amongst injecting drug users and the wider community. The success of needle exchange programmes, however, is dependent upon co-operation from various government agencies and non-government agencies, in addition to the local communities. To this end mechanisms ensuring co-operation, training, monitoring and evaluation need to be developed alongside the introduction of needle exchanges.

Adult↗
PubMed1995

A late, fatal complication of a high energy thermal injury to the scalp.

Marjolin's ulcer is an uncommon condition in which malignant transformation occurs in a chronic inflammatory focus. It was originally described in association with a thermal injury, however, its occurrence with protean chronic inflammatory foci has been described. We report the occurrence of and aggressive squamous carcinoma 3 decades after a high voltage electric mark injury to the scalp. This is the first such case described in the literature. The case supportively highlights the role of chronic inflammation and sepsis in epidermal scar cancer development, and it underlines the importance of appropriate wound management initially and expeditious treatment of sepsis and resistant skin ulceration because the malignant behavior of these tumors is aggressive and unpredictable.

Carcinoma, Squamous Cell↗
PubMed1995

Radiation protection requirements for medical x-ray film.

Previous darkroom shielding requirements for medical x-ray film-assumed that the film should not be exposed to diagnostic x-ray radiation levels greater than 2 microGy (0.2 mR) for the life of the film. Modern medical x-ray films are much less sensitive to ionizing radiation, with most films showing at least an order of magnitude less sensitivity than previously assumed. Conversely, these same films when loaded in cassettes using modern intensifying screens exhibit an order of magnitude greater sensitivity when these cassettes are exposed to ionizing radiation. These data suggest that protection of modern medical x-ray film, stored in a darkroom, may require less shielding than previously assumed. Conversely, film loaded in a cassette will require greater shielding.

Radiation Protection↗
PubMed1995

Aortic distensibility and stiffness index measured by magnetic resonance imaging in patients with Marfan's syndrome.

OBJECTIVES: To use magnetic resonance imaging to measure the elastic properties of the aorta of adults with Marfan's syndrome and to compare these results with those obtained by echocardiography. PATIENTS AND METHODS: 12 patients with Marfan's syndrome and 12 controls matched for age. Transverse luminal areas of the ascending and descending aorta were measured using electrocardiographic gated magnetic resonance imaging. Echocardiography was used to measure the diameter of the ascending aorta and aortic arch in patients with Marfan's syndrome. Blood pressure was measured during both scans. RESULTS: In diastole, transverse luminal areas of the ascending and descending aorta were significantly greater in patients with Marfan's syndrome when measured by magnetic resonance imaging and corrected for body surface area; P < 0.02 and P < 0.05 respectively. Patients with Marfan's syndrome had a higher stiffness index (112.77 v 5.78, P < 0.05) and a lower distensibility (0.0066 v 0.0105, P < 0.05) than controls. Results produced by MRI and echocardiography were not significantly different. CONCLUSIONS: Magnetic resonance imaging gives good quality reproducible images of the ascending and descending aorta. In patients with Marfan's syndrome, aortic distensibility and stiffness index measured by magnetic resonance imaging were abnormal (but did not always relate directly to the size of the aorta.

Adult↗
PubMed1994

Molecular and pharmacological characterization of the human CCKB receptor.

The human cholecystokinin B (CCKB) receptor has been isolated from a human temporal cortex cDNA library. Transient transfection of the receptor into COS-M6 cells resulted in high specific binding of 125I-sulphated CCK-8 labelled with Bolton and Hunter Reagent (KD = 31 pM). Competition experiments yielded the expected CCKB receptor ligand binding profile for agonists and antagonists. Similar results were obtained in human small cell lung carcinoma cells, which express an endogenous CCKB receptor. Extensive functional characterization of the receptor was performed in stably transfected HeLa cells using intracellular calcium imaging and microphysiometry techniques. Molecular analysis of the human CCKB receptor using Southern blotting of genomic DNA suggests the presence of a single gene for the CCKB receptor with no closely related homologues. This was confirmed by the polymerase chain reaction cloning of identical receptor coding sequences from human small cell lung carcinoma cells and human gastric enterochromaffin-like cell-oma (ECLoma) tissue.

Animals↗
PubMed1994

A candidate tumor suppressor gene in human breast cancers.

We have isolated a candidate gene (designated Brush-1) located at 13q12-q13, proximal to the retinoblastoma gene (RB1). Brush-1 codes for a 4.7-kilobase mRNA expressed at high levels in normal breast epithelium but drastically reduced in 6 of 13 breast cancer cell lines. RB1 mRNA expression is at normal levels for 5 of these 6 lines suggesting a greater importance of Brush-1 for breast cancer. Four primary breast tumors which showed no loss of heterozygosity in the 13q13-q14 region demonstrated normal levels of mRNA for both Brush-1 and RB1. However, four additional primary tumors which displayed loss of heterozygosity for this region had markedly decreased levels of Brush-1 mRNA while maintaining the normal levels for RB1. This differential loss of Brush-1 mRNA expression for both primary tumors and breast cancer cell lines is the expected pattern for a breast tumor suppressor gene.

Base Sequence↗
PubMed1994

Physical mapping of chromosome 17 cosmids by fluorescence in situ hybridization and digital image analysis.

We used fluorescence in situ hybridization and digital image analysis to localize cosmids along human chromosome 17. Seventy-one cosmids were selected at random from a chromosome 17 library constructed from a partial Sau3AI digest of flow-sorted chromosomes from a mouse-human hybrid cell line. Sixty-three of these (89%) gave a signal only on chromosome 17. The 40 cosmids producing the most distinct hybridization signals in metaphase and interphase cells were precisely mapped using digital image analysis. An additional 20 cosmids, previously mapped by linkage analysis, were also mapped. The order of these probes determined by metaphase mapping was consistent with the order determined by linkage analysis.

Chromosome Mapping↗
PubMed1994

Flumazenil has an anxiolytic effect in simulated stress.

This study was designed to test whether or not flumazenil (1 mg IV) would change levels of anxiety induced by simulation of public speaking (PSS). Forty normal volunteers were randomly allocated in a parallel groups design to treatment with flumazenil or placebo (double-blind) and one of two stress conditions (PSS/control task). PSS increased anxiety and flumazenil antagonized this effect. The anxiolytic activity of flumazenil was particularly strong on anticipatory anxiety measures. The results were discussed in terms of the involvement of endogenous benzodiazepine-type ligands in the regulation of the human response to stress.

Adolescent↗
PubMed1994

Effects of concurrent diazepam treatment on the outcome of exposure therapy in agoraphobia.

In a study designed to evaluate the impact of benzodiazepine use on the outcome of behaviour therapy, 91, severe, chronic agoraphobics (46 BDZ users and 45 non-users) were randomly allocated on a double-blind basis to in vivo exposure with low-dose diazepam (ED) or placebo (EP). Drug doses were adjusted on the basis of weekly psychiatric assessments over weeks 1-4. Patients had 8 x 2 hr exposure sessions (weeks 5-12) and were then withdrawn from medication (weeks 13-16). Re-assessments were completed at weeks 4, 12 and 16, and follow-up assessments at approx 20, 46 and 72 weeks. In the analysis of the results, the clinical outcome was evaluated in relation to the therapeutic regime (ED vs EP) and prior BDZ use (users vs non-users). The results showed that the ED group had greater changes in anxiety than the EP group during the drug manipulation phases (anxiety increasing during BDZ withdrawal). There were no group differences in agoraphobic symptoms and no evidence that the outcome of the behavior therapy was significantly affected by concurrent BDZ treatment. There were significant improvements in agoraphobic symptoms over the treatment period, with no evidence for relapse of treatment gains on withdrawal from BDZ, nor for differential responses over the one year follow-up. Initial differences between users and non-users were less marked than expected, although there was a trend for more drop-outs among users across both ED and EP groups.

Adult↗
PubMed1994

Enterococcal bacteraemia: a prospective study of 125 episodes.

One hundred and twenty-five episodes of enterococcal bacteraemia occurring over a 50-month period were studied prospectively. Enterococcus faecium was the commonest species, accounting for 76 (59.8%) of the 127 isolates. Overall, 33.1% of isolates were resistant to ampicillin and one isolate (0.8%) to vancomycin; high-level gentamicin resistance was detected in 4.3% of 93 isolates tested. The percentage of nosocomial episodes was 70.4, and 95.2% of the patients had significant underlying illness. Central venous catheters (CVCs) were the commonest source of infection. Eighty-four per cent of episodes were ultimately treated with appropriate antibiotics. The overall mortality rate was 17.6%, and that directly attributable to infection was 8.0%. An increased mortality rate was observed in intensive care and neonatal unit patients, and in patients who had received antimicrobial therapy in the 2 weeks prior to enterococcemia. CVC-related infections were associated with a reduced mortality. No other clinical or microbiological factors were found to influence outcome.

Ampicillin Resistance↗
PubMed1994

Acquisition of cytomegalovirus infection by premature neonates.

In order to evaluate the risk of premature infants acquiring cytomegalovirus (CMV) infection, a prospective study was made of infants of 32 weeks gestation or less admitted to a neonatal unit. Infants were assessed at birth to exclude congenital CMV infection and followed to the age of 1 month post-term. A total of 16/131 (12.2%) infants acquired CMV infection; 6 of CMV antibody-negative and 10 of CMV antibody-positive mothers. Six of 65 (9.23%) infants of CMV antibody-negative mothers who had been transfused with blood acquired CMV infection compared with 0 of 18 infants of CMV antibody-negative mothers, and who had not been transfused with blood. Acquired CMV infection was also more common in infants of CMV antibody-positive mothers and who had been transfused with blood, i.e. 9 of 34 (26.47%) compared with 1 of 14 (7.14%). The relative risk was 3.7 (95% confidence interval 1.53-5.87). This study suggests that all premature infants requiring blood transfusion should be transfused with CMV antibody-negative blood regardless of the CMV immune status of their mothers.

Antibodies, Viral↗
PubMed1994

Anti-Proteus antibodies and Proteus organisms in rheumatoid arthritis: a clinical study.

We have studied anti-Proteus antibodies (APA), isolation of Proteus, and their relation to various measures of RA disease activity. Seventy RA patients with a CRP > 10 mg/l had higher APA titres than 17 RA patients with CRP < or = 10 mg/l (P = 0.006), and 36 non-RA controls (P = 0.003). However, in a cross-sectional study of the RA group, there was no correlation between APA and a number of clinical and laboratory measures of disease activity, including the CRP and Stoke RA activity index. A longitudinal study showed no correlation between changes in these measures of disease activity and change in APA titre. We were unable to isolate Proteus in the urine or faeces of RA patients more frequently than controls, and the isolation of Proteus did not correlate with serum APA titres. Urinary APA was present in equal frequencies in RA and non-RA patients. NSAIDs, DMARDs and steroids did not appear to influence APA titres in the RA group. These results suggest that APA may act as an acute phase protein, distinct from CRP, but not correlating with RA disease activity in its broadest context. The fact that the antibody we are measuring binds to Proteus may be irrelevant, and the study does not support a role for Proteus in RA.

Adult↗